If you are providing in home care for someone with Alzheimer’s disease, or in home care for someone with dementia in the Dallas, TX area, then you probably experienced the challenges getting that person to a doctor appointment.  Care Mountain home health care has over 30 years home health care experience helping families with this issue and wanted to share from this in hopes that it may help you too.

Of course there is no one strategy that works equally well in all situations – the stage and type of dementia will certainly make a difference.  For the purpose of this article, we will focus on working with those in the more advanced stages of Alzheimer’s and with the more common types of dementia (Alzheimer’s disease & vascular dementia).

For you this may be all about the doctors appointment, but for the person with dementia it is all about the journey, which starts as soon as they awake the day of the doctor appointment.  The focus of the journey is about staying within their comfort zone.  Redirection, simplicity and a feeling of being safe and secure are key factors for staying within this comfort zone.

Simplicity is about keeping the stimuli one is exposed to within manageable limits.  With diminished cognitive capacity, a person with dementia can become easily overwhelmed leading to heightened levels of agitation that will make any type of compliant behavior challenging for you.  This is probably one reason many report best results with doctors appointments in the latter part of the morning.  Some of the more intense and higher concentrations of stimuli occur within the two hours after awakening when challenged with all the tasks of toileting, bathing, personal hygiene, dressing and eating. Taking off to the doctor right after all this leaves them with little cognitive reserve left to cope with much else, which is why a little recuperation time bringing you to the later part of AM works better.  Traffic conditions will be more ideal at that time as well as the positioning of the sun (less sun glare) which further minimizes undesirable stimuli (for both of you). As the day goes on a person with diminished cognitive capacity will become more quickly exhausted, which will further inhibit compliant behavior.

Where most caregivers seem to miss on simplicity is in providing too much unnecessary detail to the person with dementia – more (detail) is usually not better here.  Keep your focus on the experience not the explanation.  Enjoyable music or a quiet peaceful ride will usually win out over detailed explanations. Once you settled into that comfort zone, redirecting will help you stay there.

Successful redirecting involves the most simplistic path/method to one’s comfort zone. When you see the person becoming agitated, find the most simplistic way of getting them (re)focused on what you know makes them feel good.  Once again, staying in this comfort zone is the surest way to minimize the challenges facing this trip to the doctor.

As a person with dementia ventures away from home, the unfamiliarity surrounding them leads to a need for a more comfortable sense of safety and security.  One of the best ways to meet this need is by being accompanied by someone the person with dementia is exposed to frequently and who cares deeply about them.  If your spouse has dementia, even at advanced stages, I am sure you have seen how your presence brings upon this sense of safety and security back into that comfort zone.

Another way you can make the journey more manageable is by shortening it as much as possible, or even it eliminating it by using one of the many companies now providing doctors that make house calls.  Some of the more notable doctor house call companies in the Dallas, TX area are:  Baylor Scott & White House Calls, Kindred House Calls, Esteem House Call Physicians, House Calls Plus, Family Health On Call, Medinet Healthcare House Call Doctors, Texas Physician House Calls, American Visiting Doctors, Visiting Physicians Association, Transitions House Calls, Healthy House-Call Providers, Carmel Care, and Omni Wellness Group.

Some excellent resources can also be found at the Greater Dallas Chapter of the Alzheimer’s Association and at the North Central Texas Chapter of the Alzheimer’s Association.

A good example from a Care Mountain client to share is from Allen who called us for home health care in Allen, TX  to help with his wife who was in the later stages of Alzheimer’s disease. Allen had been caring alone for his wife for the past seven years and had called us because he was no longer comfortable driving his wife alone to doctor’s appointments. Allen was doing all the right things as was mentioned in this article, but he was just not in the best of health himself anymore, which is mainly why he needed the help. To best help him we ensured he had the same caregiver to go along with him each time to the doctor. With any type of dementia, caregiver consistency is very important!  On thing Allen did that worked well was to take his wife through the Braum’s drive through window for her favorite ice cream on the way to the doctor – a comfort zone for her.  The caregiver helped maintain that comfort zone by maintaining enjoyable music during transport and by ensuring Allen’s wife got around safely, so he could give himself the needed focus to ensure he didn’t fall.

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How To Best Get A Person With Alzheimer’s or Other Dementia To Doctor Appointments: Dallas, TX; Allen, TX & Frisco, TX Area Caregiver Guide

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